[feministism]

[israelmekaniko]

“THE LAST PIECE SYNDROME”

Kapag umoorder kami ng pizza, ‘matic na unahan agad sa pagkuha in all forms. Wala ng instagram at #flatlay na ganap. Pizza yan eh. Ang target, yung pinakamalaking slice at yung may pinakamaraming toppings. Pero kahit gaano kagutom ang lahat, minsan may isang slice pa rin na natitira. “Last Piece of Shame” or “Victim of Diplomacy” daw ang tawag dun. ( Lakas makasosyal right?) Yung tipong dedmatology yung mga kasama mo dun sa huling slice na parang di nila napansin pero gustong-gusto naman nilang kainin mula sa kaibuturan ng kanilang mga bituka. Nagpapakiramdaman lang. Kase nga, kapag kinain mo yun, parang ikaw ang lalabas na pinakamatakaw at pinakapatay-gutom sa balat ng lupa. Wala naman kasing magbibilang kung ilan yung nakain mo pero palaging may magtatanong kung sino ang kumain ng huling piraso. Pero pwede din na mas iniisip lang natin na baka meron talagang mas may gustong kumain ng huling slice na ‘yon, bumubwelo at tumatiming lang. Kaya ang tendency, hihintayin mo na lang na may kumuha. Hanggang sa ang ending, walang kumain. Nanigas na ang crust pero walang pumansin.

*Kawawang huling piraso ng pizza.

Siguro habang nag-iisa siya dun sa gitna, wala siyang ibang ginawa kundi magself-pity. “Siguro dahil ako ang pinakamaliit na slice. Ako yung may pinakakonting toppings kaya walang may gustong kunin ako. Oh mundong kay lupit, bakit.” Parang ganon. Tapos sisisihin niya si VP Leni kung bakit hindi pa itinataas ang mga katulad niyang nasa laylayan. Pero ang totoo, hindi naman talaga yun ang issue. Umaarte lang yung pizza kase moment niya ‘yon.

Pero hindi alam ng tirang pizza na maraming naghahangad sa kanya. Nagparaya lang yung isa dahil alam niyang merong mas higit na gutom kesa sa kanya. Kaya lang, hindi naman din siya magawang maipaglaban dahil mas iniisip niya ang sasabihin ng mga tao sa paligid niya.

In a world full of “Kainin ninyo na yan. Nagtira pa kayo.”, be a “Huy. Akin na ‘to ha!”

Minsan, hindi kusang makikipaglaban ang isang bagay para mapunta sa’yo. Hindi aayon ang gravity at ikot ng mundo. Pero kapag gusto mo, ipaglaban mo. Kung alam mong para sa’yo kunin mo. Kasi baka sa huli masayang lang. Kaharap mo na, pinakawalan mo pa.

–

From a Patay-Gutom sa Pag-ibig’s Point-of-View

[israelmekaniko]

“SAAN NGA BA TALAGA TAYO KAKAIN?”

1. “Kayo bahala.”

Tapos pag nagsuggest ka biglang sasabihin,

“Dun na na naman? Wala na bang iba?” o kaya, “Sure na bang diyan?”

And you were like, “Try mo kayang pitikin yung mga neurons mo baka sakaling makapagsuggest ka.”

2. “Kahit saan.”  

Sarap tampalin ng world map sabay sabing, 

“There are 7 continents and 196 countries in this world. Before may 7,107 islands ang Pilipinas. Ngayon may 7,641 na and you’re teling me na kahit saan?!”

3. “Libre mo?”

“Nagtanong lang manlilibre na agad? Magtrabaho. Magsumikap. Mag-ipon. Hindi yung puro palibre.”

4. “Hindi ko alam.”

Sarap sagutin ng, “Hindi ko na din alam kung isasama pa kita sa susunod na lakad.”

5. “Saan nga ba masarap?”

”Sana sarili ko na lang yung tinanong ko di ba. Ako na nga ang nagtanong tapos ibabalik pa sa’kin yung tanong. So dapat kapag umorder ka, ako din kakain ha?”

6. “Dun sa pwedeng Pang-IG.”

“Yung totoo, kakain o magphophotoshoot? Itatae mo bukas, ngayon ang broadcast?”

7. “Dun sa hindi ko pa nakakainan.”

“So gusto mong magtime-travel pa ‘ko sa nakaraan para malaman ko lahat ng kinainan mo bago makapagdesisyon kung saan tayo kakain?”

8. “Walang TAYO.”

“So uulitin ko para maliwanag. Saan “IKAW AT AKO”  kakain?”

9.  “Dun sa hindi mo afford!”

Kaya ang ending, nakadungaw ka lang dun sa may bintana habang pinagmamasdan silang kumain naghihintay ng tira-tira.

10. “Busog pa ako.”

“Makasarili. Sakim. Ganid! So paano naman kami??”

11. “Siyempre dun sa hindi ka kasama.”

Kase ang bossy mo daw. Tatanung-tanong ka kung saan kakain tapos pag nagsuggest naman sila, ang ending ikaw din naman nasusunod.

12. “Sa plat…

“Wow.”

“Genius.”

“So funny.”

“Living Legend.”

“Comedy King.”

13. “Dun tayo sa mahal!”

Dahil alam niyang nasa tabi-tabi lang ang itinakda. Ang itinakdang manlilibre sa araw na iyon. Kaya kelangang samantalahin ang pagkakataon. #LaLunaHungry

—-

Tapos magtataka kung bakit failed-ibig? Kakainan na nga lang hindi pa mapagdesisyunan kung saan. Paano pa kaya ang maghandle ng relasyon at harapin ang mga consequences sa buhay?!

Dun tayo sa taong may direksyon ang buhay.

[cartiercocaine-blog]

[poqari]

There is something about sunlight that makes life seem just a little less horrible

[whatthebec]

it’s the vitamin d bitch

[yourakh]

‏لا تعطي الناس أكثر من حقها فالورد يموت من كثرة الماء ‏ ‏Don’t give people more than they deserve, for even a rose dies from too much water

[bob-belcher]

[israelmekaniko]

naniniwala kaba sa famous line na, "kapag nagmahal ka ng dalawa, piliin mo un pangalawa dahil hindi ka naman hahanap ng iba kung mahal mo talaga yun una"

Magkaiba kami ng pananaw ni Pareng Bob Ong.

Mataas ang tingin ko sa konsepto ng pagmamahal kaya naniniwala ako na hangga’t may ibang laman ang puso ng isang tao, hindi yun kayang palitan ng ganung kadali lang. Hindi pagmamahal yung nararamdaman mo sa pangalawa kundi pagkukumpara lang sa nauna.

Nakita mo lang bigla yung mga kakulangan niya na wala dun sa isa kaya akala mo mahal mo na.

Ang minahal mo ay ang ‘kawalan’ at kakulangan ng taong ipinagpalit mo na natagpuan mo sa iba dahil hindi ka marunong makuntento.

Kaya dun pa rin ako sa una.

[mr-ekasinga]

someone: you won't feel this way forever (: it'll get better

me, who's been this way nearly all of my life, felt this awful since age 10 (and the years before that probably if i could actually remember them in detail and didn't repress 95% of what happened), who's been told the exact same thing, verbatim, for years, as things have either stayed the same or gotten worse: ok

[veronicaneptunes]

Kristen Bell on double standards and how there is no shame in having Anxiety and Depression.

[trueliesfalsetruths]

17 Reasons Why ER Nurses Should Get Paid More

It’s obvious to everyone that nurses are overworked, understaffed, and underpaid. But ER nurses have it worse. Here are the 17 reasons why ER nurses should get paid more.

1. We are the hospitals first responders (not including EMS). This means hours of hazmat, disaster, and Ebola training in that hazmat suit that I call a Dutch oven. Tips for you future ER nurses, no bean burritos before hazmat class. No bueno.

2. What’s phlebotomy? Yeah we don’t have that luxury.

3. I might start putting Hospital Transporter on my resume. Yeah, we transport our own pt’s and pray that the other 8 we left wont code on us.

4. House keeping, house keeping, house keeping, I have my bachelor’s degree (with honors i might add) and were talking about house keeping (this is an Alan Iverson reference). The ED can’t always wait for housekeeping to clean the rooms so we do it.

5. We are the IV start team. EJs and ultrasound guided IVs, yeah we do them. NBD. In smaller hospitals we get called to start IVs on the floor when the floor nurses can’t. We don’t use a vein finding machine; we are walking, talking, vein finding, IV inserting machines.

6. Things you’ll never hear an ER nurse say “My pt’s getting sicker I think I’ll call another nurse to take care of them, because I can’t”. Or how about this one “Call the Rapid Response Team!” “Call a Code Blue!”. We are the rapid response team, we run our own codes, we don’t panic. We are ER nurses, we are badasses.

7. BLS, CPI, ACLS, PALS, TNCC, ENPC, Burn Certified, NIH Stroke Certified, CEN… It’s like getting another degree every 2-4 years.

8. Floor nurses get RN-RN report and they can also read all of the health care notes. ER nurses get pts long drawn out story that makes no sense whatsoever, with a garbage bag full of meds to chart.

9. Dear floor nurses, have you ever had pt’s in the hallway because you don’t have enough rooms? Oh no? Sounds like an ER nurses wet dream.

10. We work with every pompous jack ass medical school can produce. we work with every single cocky interdisciplinary teams ever created. Floor nurses only work with a few that are specific to their unit. You guys have real relationships, we’re just used and abused.

11. There is no such thing as a limit on pt/nurse ratio for ER nurses (at least in Michigan). Sound safe? I mean I like living dangerously. Are we putting our license on the line, more so then floor nurses?

12. We have forgotten what techs (pca, cna, nurses aid) looks like. They’re far and few between. Please hire more of them! They are not just ancillary staff.

13. Don’t get me started on core measures. Most of them initiated by ER Nurses, and they’re timed. Bad flashbacks to timed tests in college just happened.

14. Do you know what pepper spray tastes like? We see a higher % of combative pts then floor nurses. I mean has your floor ever run out of leather restraints? It gets pretty kinky in the ER.

15. If we have “hold pt’s” that means we are the floor and we are also doing your job, which means we are also ICU, SICU, MedSurg, and Peds nurses. However, unlike the ICU we don’t have a limit on how many ICU pt’s we can get. I need a moment of silence for a part of me that died just talking about it.

16. You will never have to answer an EMS call. Their network is not LTE clear.

17. We take care of drunk people. We are going to heaven.

Yes? No? Maybe? Don’t take this too seriously though, unless you’re going to give me a raise!

Jason Franco

[justsmile-and-nod-rn]

#14, 15,17 and well all of them! 

[sarcasticbabywhispererjess]

This sounds awful… I want it.

[medicalstate]

As the popularity of smartphone of tablet computing expands, so too does the library of apps. The following is a list of iOS apps that might be of interest or use for the curious, for the learners, and for the clerks.

Laboratory

LabDx: A reference tool for common laboratory investigations.

Acid Plus: A calculator tool that helps tease out the type of acidotic or alkalotic process involved.

Lytes: A basic reference to the common electrolyte abnormalities, the causes, signs, and symptoms.

Calculators

BiliTool: An online tool that has an optimized mobile format, this tool helps calculate bilirubin levels in neonates and gives recommendations based on the risk stratification of jaundice.

Qx Calculate: A free calculator for many of the formulas and algorithms in medicine including risk calculators and unit conversions.

MedCalc Pro: A premium calculator that has a more streamlined design and more formulas than Qx Calculate. It also allows you to save patient values for use in multiple calculations.

Pharmaceutical

Lexicomp: The standard for monograph information, this subscription-based app includes routine updates to the drug database for newly added medications and warnings. It includes a drug interactions calculator.

Epocrates: For the free alternative, Epocrates continues to be a favorite among my classmates and attendings. It includes the standard dosing and regimens for medications but offers less detailed information regarding them compared to Lexicomp.

Micromedex: Another decent alternative that is updated regularly with the most recent warnings and medications. There is a basic free form with premium add-ons including the drug interactions tool.

Anatomy

Netter’s Anatomy Atlas: Netter is a household name in the world of medical illustrations and all of his anatomical plates have been compiled in this app. A good quick reference of study tool.

Pocket Anatomy/Essential Anatomy: Moving into the third dimension, these two apps despite a premium price, a useful study tool for anyone interested in medicine.

Muscle System Pro III: For the anatomical enthusiast wishing to see muscles in all their detail and intricacies. Premium.

Skeleton System Pro III: For the anatomical enthusiast wishing to see bones in all their detail and intricacies. Premium.

Brain and Nervous System Pro III: For the anatomical enthusiast wishing to see nerves in all their detail and intricacies. Premium.

Radiology

Radiology 2.0: One Night in the ED: A case-based radiological app that goes through the common presentations with a methodical approach.

Clinical

Medscape: A basic app that includes drug interaction calculator, a procedures reference and daily news in the world of medicine.

Skyscape: A free app that includes a number of resources to help with clinical decision making. Designed to be a one-stop shop, you can purchase and subscribe to more features and resources within depending on your needs.

Eponyms: For the medical student, half the battle is learning the language of medicine. Eponyms explains the common and obscure terms and signs of medicine named after their discoverers. 

Bugs and Drugs: A reference tool for antimicrobial therapy, the dosing guidelines and the sensitivity tables of all antibiotics.

PEPID: A clinical companion tool that provides summary information around conditions, include a brief explanation of the condition, the investigations, differential, and the treatment plan. Written in a concise form for the learner on the go.

UpToDate: The clinical companion tool that is a favourite among the attendings. This subscription-based app comes in both an online or offline version and mirrors the desktop counterpart. Including in-depth review of disease states and clinical pearls surrounding therapy.

DxSaurus: A differential diagnosis generator that works around your working diagnosis or the symptoms you see.

Reference

The Merck Manual: Professional Edition: A digital, pocket version of the original reference. Disease states can be searched by section or by symptom.

Toronto Notes 2012: While not exactly an app, this textbook is an excellent reference for any medical student and is one that I read during quiet moments on shift. A digital copy of this textbook stays with me in my eBooks library.

Principles and Practice of Hospital Medicine: This is also not an app but an eBook. An excellent reference for internal medicine, it offers great deal of information and clinical pearls for the hospitalist. 

Tools

Google Translate: For the moments where language is a barrier, this could be the only useful way to gather patient information.

Flashlight: For the times on call where we do not want to disturb other patients in a dark room as we make our way around.

Evernote: A note-taking tool to keep and sort out clinical pearls or to document clinical moments.

Drive/Dropbox: A cloud-based service like Drive or Dropbox offers an opportunity to store algorithms, guidelines, or textbooks that you can access anywhere. Now available on your phone or tablet.

Review

USMLE World QBank: For the medical student preparing for exams, the QBank is an important resource to have.

This list is by no means exhaustive but is a good starting point for readers out there interested in finding medical apps. What apps do you use?

[bottleoftonic-blog]

Most bang-for-buck things every intern should know before starting inpatient wards

Source. A collection of Meddit resources and advice on what bread-and-butter topics interns would most benefit from brushing up on/memorizing prior to the beginning of their internship. 1) Fluids. How and when to use them, dosage, timing and other pearls.

Review of fluids (not how to use them per se) by Dr. Strong /u/ericstrong

Maintenance Intravenous Fluids in Acutely Ill Patients - NEJM.

Pretty thorough review of fluid management on openanesthesia.org

2) Nausea. When to treat, how to treat and at what dose.

3) Standard pn orders: pain killers, sleep aids and antiemetics aka how to reduce nighttime calls from nurses by 25%

4) “Reflex” antibiotic choice for routine inpatient infections.

http://www.bpac.org.nz/Supplement/2013/July/antibiotics-guide.aspx /u/ChristianM and /u/ive_been_up_allnight

5) Initial work-up and treatment of dyspnea. (more realistic to approach by symptoms as, unfortunately, you first have to diagnose whats wrong. E.g. heart failure, pulmonary edema, embolism, COPD, pneumonia).

6) Initial work-up and treatment of oliguria/anuria.

7) A sensible initial approach to suspected ileus.

8) Blood. When, how, why to replace.

9) Pain. Optimal management without inducing narcosis.

Managing cancer pain: Frequently asked questions: CCJM

10) Potassium. When, why and how to shift or replace.

A review on both potassium and sodium disorders by Dr. Strong /u/ericstrong (Not reposted in 12) hyponatremia but applies there as well) https://www.youtube.com/playlist?list=PLYojB5NEEakXVIAapcSEleP4doUdHVtld

11) Hyponatremia. Most common electrolyte disturbance, commonly mismanaged.

12) Resuscitation aka commit the ACLS algorithms to memory.

Current ACLS guidelines. https://www.acls.net/aclsalg.htm

Would love a video series, interactive cases etc.

13) Basic EKG interpretation.

Whole EKG video courses

A whole free youtube EKG video review course by meddit’s own u/ericstrong

An alternative EKG course that takes you through all the basics. This however has no free version and costs 96$ a year. The quality is amazing. Here are 6 basic sample videos on youtube. The paid course is available on http://www.ecgteacher.com/

I have to admit I haven’t used this course personally but his free youtube videos are on-point and he seems like a good teacher. Also behind paywall. Free youtube samples are here. The full course can be found here https://www.ecgacademy.com.

EKG video cases

Amazing case-of-the-week emergency medicine EKG videos on youtube by Dr. Amal Mattu

– If you like Dr. Mattu’s cases (and you most certainly will) he is still posting every single week on his new site https://ecgweekly.com. It costs 4 starbucks coffees a year and is going to save someones life.

Practice EKGs with answers

Watching videos isn’t enough, you still have to grind out EKGs to keep your game strong. Visit http://ecgmadesimple.com and http://ecg.bidmc.harvard.edu/maven/mavenmain.asp for this.

EKG blogs

I recommend signing up for some kind of RSS feed (e.g. https://feedly.com/) and subscribing to the following EKG blogs:

http://hqmeded-ecg.blogspot.is (Dr. Smiths ECG blog)

http://www.ems12lead.com

http://ecg-interpretation.blogspot.is

http://jhcedecg.blogspot.is

EKG resource libraries

Life in the fastlane has a nice resource to look up a specific EKG finding, criteria or concept.

http://www.practicalclinicalskills.com/ekg.aspx /u/collidge

14) Know when to order ABGs and how to interpret them.

Almost too detailed video lecture series on ABGs and how to interpret them by Dr. Eric Strong (/u/ericstrong)

Practice makes perfect. ABG interpretation generator. https://abg.ninja/abg

Bonus 15) Basic CXR interpretation

CXR video lecture course

Again, Dr. Eric Strong has an excellent video course for free on youtube

Step-by-step guides to basic CXR interpretation

The Radiology Assistant: Chest X-ray - Basic interpretation

Radiology Masterclass step-by-step basic CXR

University of Virginia’s step-by-step basic CXR

All inclusive resources

The art and science of thoracic imaging All inclusive resource for all things thoracic! Jokes aside amazing resource.

UPenns CXR learning website

Loyola Universities excellent CXR Atlas Most outdated look but amazing content.

Checklist approach to CXR

Bonus 16) Overnight o-shit-what’s-that Head CT interpretation

Midnight radiology: Emergency CT of the head

University of Virginia’s guide to the Head CT

[sothisisnursingschool]

Hey, self: review before NCLEX. Xo, me.

[md-admissions]

Oh hell yes

[bastardcomics]

My new life goal is to make this into a t-shirt. Maybe that’ll be 2016.

[mutant-titmouse-deactivated2023]

This should help most medic students. Above: how Right Side & Left Side heart failure presents. Middle: most of the drugs you will see when it comes time for your Nat-Reg Practicals. Know the trade & generic names, routes & Doses. Bottom: mnemonics for your anti-arrhythmic drugs.

Go forth & save lives!

[staypozitive]

[staypozitive]